Your First Gynecologic Exam

A woman’s first gynecological exam can be an intimidating experience. Having a clear understanding of what will happen can help to alleviate any anxiety.

When to Start

You should begin having regular gynecological exams when you become sexually active or when you turn age 18, whichever comes first. You should schedule your exam for a time when you are not menstruating because the blood may interfere with viewing the cells needed if a pap smear is performed. You may also want to refrain from sexual intercourse for 24 hours before your appointment.

Other Symptoms That Call for an Exam

You should make an appointment immediately if you experience any of the following: severe pain in the abdomen or pelvis, unusual pain in the vagina, unusual discharge, itching or bumps in or around the vagina, exposure to a sexually transmitted disease, severe pain during menstruation, abnormal periods, breast discharge, changes in the size or skin of the breasts, or pain during intercourse.

Your Health History

The appointment will begin with your personal and family history. Some of the common questions you should be prepared to answer include: Is there any history of breast disease or cancer of the reproductive organs in your family? At what age did you begin menstruation? When was the first day of your last period? How long does your period usually last? Do you have a light, medium, or heavy flow? How many tampons or pads do you use the first day of your period? Are you sexually active? Do you have multiple partners?

Some of these questions can be extremely personal and you may feel embarrassed, but it is essential to your care that you be honest with your physician. You should also feel comfortable asking questions of your doctor. Remember that your doctor is a professional - to him or her, these questions are perfectly normal and are asked of them routinely by patients. Some women find it helpful to write down their questions ahead of time so that they don’t forget anything.

Physical Exam

After you and the doctor have discussed your medical history and addressed your questions, you will begin the physical exam. The doctor will conduct a breast exam and show you how to perform routine self exams.

Next you may be given a pelvic exam. The doctor may examine the external genital area for signs of irritation, discharge, cysts, genital warts, or other problems. The doctor may insert a speculum to separate the walls of the vagina. The speculum can feel a little strange but relaxing and breathing normally will minimize any discomfort. Once inserted, the doctor can examine your cervix and vaginal walls.

Pap Smear

You may be given a Pap smear. This involves collecting, with a small brush or spatula, cells from the cervix. This may feel a little uncomfortable but it is done very quickly. A pap smear is used to detect the presence of pre-cancerous or cancerous cells, certain types of cervical changes, or infections. If you are being tested for any sexually transmitted diseases the doctor will collect a sample of cervical mucus on a cotton swab.

The speculum will be removed and the doctor may examine your internal organs, the uterus, fallopian tubes and ovaries. This is done by inserting one or two fingers into the vagina while pressing down on your abdomen.

The entire physical exam only takes a few minutes. The results of your Pap smear are usually ready in a week or two. If there are any problems detected, your physician will contact you and schedule a follow-up for further testing.